Senior Medical Coding Specialist

1 day ago

Tarlac City, Central Luzon, Philippines beBeeMedicalCoding Full time ₱450,000 - ₱600,000

We are seeking a seasoned Medical Coding Specialist to join our team. This is a remote opportunity that offers flexible work arrangements and a competitive compensation package.

Job Description:

The successful candidate will be responsible for conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution. The clinical content could include additions, deletions, or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations, and other clinical content criteria.

  • Research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria for our automated claims editing solution.
  • Provide written and oral presentations to medical directors (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria.
  • Provide clinical content support to our customers as needed.
  • Perform data entry of clinical content updates into database, as needed.
  • Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within Lyric business rules.
Required Skills and Qualifications:
  • Bachelor's Degree in Nursing.
  • Active RN (PRC) License.
  • AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC).
  • At least 5 years of experience in the areas of CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing.
  • Previous experience working with US health insurance payers in a claims, appeals, or coding capacity.
  • Experience in denial management or claim review management is a plus/advantage.
  • Excellent Communication Skills (verbal and written) enabling effective communication with all areas of the business.
  • Proficient in using MS Office Applications.
  • Amenable to Work on Night Shift.
  • Amenable to Work From Home Set-Up.
Benefits:

This role offers a range of benefits including flexible work arrangements, competitive compensation, and opportunities for professional growth and development.

Others:

Please note that this is a remote opportunity and candidates must have a dedicated workspace with reliable internet access.

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